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Clinical practice guidelines (CPGs) summarize research and empirical evidence to inform the development of recommendations for clinical or policy decision making. The methodology of guideline development has evolved over the past decades, with the contribution of major organizations, such as the Guidelines International Network, the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) Working Group, and the Scottish Intercollegiate Guidelines Network (SIGN).
Further efforts have focused on the improvement of CPG reporting. The Appraisal of Guidelines, Research and Evaluation (AGREE) Collaboration developed an instrument to be used as a guide on how to design, report and assess CPGs. The AGREE II checklist and the AGREE II instrument have been adopted by several guideline-development bodies, including WHO, as reporting and appraisal tools, respectively.
CPGs on surgical interventions are somewhat unique, compared to non-interventional guidelines. For instance, surgical interventions are often operator-dependent, and they usually require specific skills and expertise. Defining the required resources and expertise to implement the recommendations might be considered important by target users and other stakeholders. Furthermore, guidelines on surgical intervention may need to provide sufficient details of the procedure to enable the extrapolation of evidence to clinical practice (e.g. the method of access and the type of stent to be used in endovascular aortic aneurysm repair), as opposed to non-interventional and pharmacological guidelines, where the management options are usually straightforward (e.g. using low molecular heparin over unfractionated heparin for prevention of deep vein thrombosis).
These considerations, in addition to advances in guideline development methodology in recent years, prompted a group of guideline developers in the field of surgery to design an extension of the original AGREE II instrument, which would apply to guidelines on surgical interventions.
In this talk we describe the development of the AGREE-S reporting checklist, an AGREE II extension for surgical interventions.